Rethinking the National Diabetes Prevention Program for Low-Income Whites

The National Diabetes Prevention Program (NDPP) is a widely disseminated lifestyle intervention to prevent diabetes through weight loss. Racial/ethnic disparities in NDPP effectiveness have been shown, with non-Hispanic whites (NHWs) losing more weight than Hispanics and non-Hispanic blacks (NHBs) (1). Income disparities in NDPP effectiveness are understudied, yet they are relevant for future Medicaid coverage of the program. We previously reported a lower-than-average weight loss for NHWs participating in the NDPP within a health care system for underserved populations (2). Here, we examined whether income status modifies the association between race/ethnicity and NDPP outcomes. The NDPP was implemented in a safety-net health care system following Centers for Disease Control and Prevention (CDC) guidelines (3). Effectiveness was evaluated among 994 Hispanic, NHB, and NHW participants. The Colorado Multiple Institutional Review Board approved this program evaluation project. Race/ethnicity, income, age, sex, and BMI were collected from medical records. Income was classified …